Wynne Health In Print

“Public Charge” Rule Would Disrupt Safety-Net Access for Some Immigrants

The Trump administration has signaled its plans to significantly alter the rule on eligibility of applicants for permanent residency and applicants intending to immigrate to the US by redefining “public charge” determinations related to the use of public benefits. This would make it harder to enter the country and reduce access to a broad range of health and human service safety-net programs for immigrants already living here, including US citizen children. ...
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The Consumerization Of Health Care To Improve Value: Secretary Alex Azar’s “Radical” Vision

HHS Secretary Alex Azar recently laid out a four-part strategy to achieve a "radical" vision of reforming health care: giving consumers greater control over health information, encouraging price transparency, using experimental models in Medicare and Medicaid to drive value, and removing government burdens. While certain elements of the secretary’s strategy reflect important reforms, his recommendations raise questions about the desirability of a shift toward consumerization of health care and whether these changes are actually in the best interest of consumers....
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Creating Medicare Advantage Premium Support For All, Part 3: Provider Considerations

"In the first post of this series, I hypothesized that a Medicare-for-all approach that puts market-based principles at its core will have the most success not only in winning sturdy, bipartisan support but in actualizing high-quality universal coverage at lower cost. In Part 2, I explored modest benefit enhancements that would be needed to maintain the quality of coverage various populations have under existing programs, some of which were reiterated in the CAP proposal. "In this post, I will examine what a Medicare Advantage (MA)-based universal coverage regime would mean for providers, who will continue to be the heart of our system and whose decisions affect the cost and quality of our care more than anyone else’s."...
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What Does Alex Azar’s Plan for Value-Based Care Really Mean?

New HHS Secretary Azar has articulated a four-point plan for value-based transformation of our health care system, but so far concrete details regarding the initiatives he will pursue are scarce. In this post, we break down the components of his plan and their potential implications for various health care stakeholders....
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The Arduous Road to Renewal of CHIP Funding

After months of uncertainty, on January 22, 2018, Congress passed legislation renewing long-term federal funding for the Children’s Health Insurance Program (CHIP). Nearly nine million children and 370,000 pregnant women nationwide rely on the program for health coverage. This post examines the pathway renewal of the program took through considerable delays and political controversies....
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State Waivers As A National Policy Lever: The Trump Administration, Work Requirements, And Other Potential Reforms In Medicaid

As states line up to avail themselves of new flexibilities in the section 1115 Medicaid wavier process, we thought it important to examine exactly what was approved in Kentucky and Indiana, and to survey the current landscape of pending proposals in search of what other reforms may be on the horizon....
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The Health Implications of Tax Reform

This post breaks down the key components of 2017 Federal tax reform and its impact on the health care sector....
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Navigating The Section 1332 Waiver Process: For States, A Treacherous Road Ahead

In light of the mounting legislative efforts to make changes to the section 1332 waiver process, especially in the Alexander-Murray market stabilization package, and enhanced state interest in availing themselves of this opportunity, we figured it timely to provide an overview of this aspect of the Affordable Care Act (ACA), the record of how state applications have been adjudicated so far, and the prospects of change to the policy in the near term. Unfortunately, given the considerable uncertainty in both the legislative and executive branches regarding the future of these waivers, states cannot safely expend meaningful resources on developing new applications for the program at this time....
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Breaking Down The MACRA Final Rule

On November 2, 2017, the Centers for Medicare & Medicaid Services (CMS) released a final rule making changes to the 2018 Quality Payment Program (QPP) under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The QPP includes both the Merit-Based Incentive Program (MIPS) and Advanced Payment Models (APMs). This post explains the key policies implemented in the final rule....
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Creating Medicare Advantage Premium Support for All, Part 2: Benefit Design

This is the second installment in my series examining the potential for a bipartisan Medicare-for-all approach that leverages competition among private payers and consumer choice via an advanceable tax credit....
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The Alexander-Murray Market Stabilization Package: What’s In It And Where’s It Going?

They may have done it. The apocryphal bipartisan deal to “fix” Obamacare is being struck (at least by two important Senators, for now, in part …). Today, Senators Lamar Alexander of Tennessee and Patty Murray of Washington announced they are converging on an agreement on a short-term package to help stabilize the individual insurance market. Even better, the policies included would likely be somewhat successful in achieving their purported purpose...
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The CHRONIC Care Act Passes Senate, Obstacles Remain

his post outlines the key components of the now adopted Chronic Care Act, assessed its outlook in the House, and considered what its progress may tell us about the prospect for more bipartisan action on health care in the future. ...
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